Understanding gene therapies

Gene therapies are transforming the pharmacy industry in more ways than one. In order to navigate these new-to-market therapies confidently, you need trusted resources and data.

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Read on to better understand the impact of new gene therapies on your member population—and what you can do about it.

What are gene therapies?

Gene therapies are innovative, highly targeted medications that can edit genetic material in a patient’s affected cells and tissues. They have a long history of research and development, and the availability of genetic therapies for both rare and common genetic conditions is about to take off.

Payment models and patient care systems need to be thoughtfully reimagined and strategically implemented, where it makes sense, to make gene therapy accessible for individuals who would otherwise lack access to these life-changing and life-saving innovations.

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Gene therapy has the potential to treat—and cure—some of these disorders, often the most debilitating diseases patients face.

Evernorth helps our clients navigate through this complex emerging landscape. We'll be your guide from pipeline tracking and planning for your impact through distribution and management solutions.

~4K
diseases are linked to gene disorders—many of which lack any effective treatment

A life-changing—but expensive— treatment option

While gene therapies promise extraordinary outcomes, few can afford their high price tags, including ones costing $850K and $4.25M per treatment.

30x

the median U.S. household income is spent per person1

$5B

to research and develop a gene therapy2

$50B+‌

forecasted gene and cell therapy costs in the U.S. by 20313

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Preparing for the impact of gene therapies

Gene therapies are quickly coming to market, and with them the potential for life-changing outcomes for some of the most debilitating conditions patients face. With these new innovations, however, come complexities for patients, their caregivers and payers.

Talking Specialty

Gene Therapies discusses what you can do to prepare now and how Evernorth’s suite of solutions and services can set you up for success.

Gene therapies, today and tomorrow

By supporting and encouraging evidence-based access to gene therapy, payers and other segments of U.S. society will be positioned to benefit from future advancements and biopharmaceutical breakthroughs that drive systemic change.

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Understanding the basics on cell and gene therapy

Gene therapies 101

We answer our clients’ burning questions about gene therapies, including how they work, whether or not they’re safe, and if we’ll see more in the future.

Understanding gene modification and cellular therapies

Gene modification and cellular therapies are unique, potentially curative treatments that leverage gene-altering technology

How to have a data-driven discussion on gene and cellular therapies

As the number of approved gene and cellular therapies grows, you can start preparing your organization now by taking the right next steps.

Understanding the gene therapy landscape

Explore the tabs for more information on gene therapies to help make impactful, informed decisions.

The need for coverage

Plans have a spectrum of coverage options to consider with the influx of novel gene and cell therapies. By offering proactive and comprehensive coverage, plan sponsors can reduce their own risk and control costs while ensuring their members have access to these groundbreaking treatments.

Have this conversation with your Evernorth account team soon.

Equip your decision makers with the right resources, pipeline insights and sophisticated modeling tools, so you can develop a clear vision for how your organization will handle gene therapy coverage. Your plan will need the right protection from million-dollar price tags, as well as a path to expand coverage for members.

Cost management

Each year comes with a new wave of approvals to plan for. Planning now for your approach to gene therapies will help you manage costs more predictably in the future. 

Expanding access

Making a coverage plan for gene therapies supports health care technology that can engineer bodies to fight cancer and reverse rare diseases—all while giving hope to so many who didn’t have it before.

Competitive benefits

Including gene therapy coverage in your benefits can help set your organization apart by illustrating your strong commitment to the health of your employees and their families.

EXPERT PERSPECTIVE
“When families face a rare and devastating diagnosis, they should be able to begin treatment promptly, without worries about how to afford vitally needed medications."

Jennie Iverson
Sr. Director, Product Management, Evernorth

At Evernorth, our solutions ease the journey to connecting those with rare conditions to life-changing drugs—from access, to distribution, to utilization.

It’s in our DNA to help members live their best lives. We understand the complexities that make it difficult to coordinate gene therapy care and coverage for both plans and members. Let us guide you.

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EXPERT PERSPECTIVE
“We create a custom clinical protocol for each therapy to ensure we are addressing the unique needs of each patient on their treatment journey."

Gail Bridges, PharmD
Sr. Director and Clinical Practice Lead, Accredo by Evernorth

Take the next step in supporting life-saving innovations

We can help you prepare and plan your gene therapy strategy to cover your members.
Explore more insights on gene therapies
Woman looking through microscope
Article
Gene therapies, today and tomorrow
April 12, 2024
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Article
Uncovering behind-the-scenes challenges in bringing gene therapies to market
June 07, 2022
Gene Therapies 101
Article
Gene therapies 101
February 12, 2020

Frequently asked questions